Business Plan - OGScapital
Business planProject EXXXXXStrictly private and confidentialXXXXXFounderEmail:
DisclaimerSectionPageDisclaimer2Executive Summary4Market Research7Business Model18Marketing Plan30Financial Projections37Management Team43Use of Proceeds46Business plan – Project E2 XXXX - Priv ate and Conf idential
DisclaimerDisclaimer This presentation has been prepared exclusively for the benefit and internal use of a qualified sophisticated global financier to whom it is directly addressed anddelivered. This presentation is for discussion purposes only and is incomplete without reference to, and should be viewed solely in conjunction with, the oralbriefing provided by XXXXX. Neither this presentation nor any of its contents may be used for any other purpose without the prior written consent of XXXXX. The information in this presentation is based upon forecasted numbers provided in industry literature and our best estimates. These projections and estimationsreflect prevailing conditions and our views as of this date, all of which are accordingly subject to change. In preparing this presentation, we have relied upon and assumed, without independent verification, the accuracy and completeness of all information availablefrom public and private sources which were provided to us or which were otherwise reviewed by us. In addition, our analyses do not claim to be appraisals of theassets, or the valuation of any entity. XXXXX makes no representations as to the actual benefits which may be received in connection with a transaction nor thelegal, tax or accounting effects of consummating a transaction. A number of statements referenced in this presentation that have been granted, are forward-looking statements, and any statements that express or involvediscussions with respect to predictions, expectations, beliefs, plans, projections, objectives, and goals, assumption of future events or performance are notstatements of historical fact and may be "forward-looking statements." Forward looking statements are based on expectations, estimates and projections at the time the statements are made that involve a number of risks anduncertainties which could cause actual results or events to differ materially from those presently anticipated. Forward-looking statements in this presentation maybe identified through the use of words such as "expects," "will," "anticipates," "estimates," "believes," or statements indicating certain actions "may," "could," or"might" occur. Any person or entity seeking to make an investment in the company should not rely on the information set forth in this business plan as complete. Any person or entity seeking to make an investment in the company should not rely on the information set forth in this business plan as complete. There existssubstantial information with respect to the company, its business and its future prospects which are not set forth in the business plan and there exist a substantialnumber of risks associated with an investment in the company which are not set forth in this business plan. Any person or entity considering making an investment in the company must ensure that they avail themselves of all other information relating to the company, itsbusiness, and its financial projections, as well as all other information deemed necessary or desirable by such prospective, prior to any such investor making aninvestment in the company. Any prospective investors shall be required to represent to the company that, prior to making such investment, they have received from the company allinformation deemed necessary or desirable by them with respect to such investment and that such investor did not rely on any information set forth in thisbusiness plan in making any such investment. By accepting delivery of this plan, the recipient agrees to return this copy to the corporation at the address listed below if requested. Do not copy, fax, reproduce or distribute without written permission from XXXXX.Business plan – Project E3 XXXX - Priv ate and Conf idential
Executive SummarySectionPageDisclaimer2Executive Summary4Market Research7Business Model18Marketing Plan30Financial Projections37Management Team43Use of Proceeds46Business plan – Project E4 XXXX - Priv ate and Conf idential
Executive SummaryThe Project E will be Botswana’s first private psychiatric hospital focused on inpatient and outpatient clinical health careMarket analysisBusiness idea Availability of mental health facilitiesTotal num ber offacilities/ bedsMental health outpatient facilitiesDay treatment facilitiesPsychiatric beds in general hospitalsCommunity residential facilitiesBeds places in community residential facilitiesMental hospitalsBeds in mental hospitals17UN99UNUN2332Rate per 100,000population0.86UN5.01UNUN0.1016.79Num ber ofRate perfacilities/beds100,000reserved forpopulationchildren andadolescents onlv10.05UNUNUNUNUNUNUNUNUNUNUNUNSo urce: Department o f M ental Health and Substance A buse, Wo rld Health Organizatio n The Project E will be Botswana’s first private psychiatric hospital focused on inpatientand outpatient clinical health care.Project E is part of the Institute Z, which also include education and researchsegments.Price: mediumGeographical focus: BotswanaTarget end-customers: people in need of mental and general medical health careand supportFounder: XXXXXGoals To become a major provider of mental health care in Botswana and,eventually, other countries as wellTo increase number of beds in the hospital from 20 to 100 over the next10 years600 inpatient admissions in year 1To complete construction of the hospital building in year 5To become a teaching affiliate for government agencies and privatehealth care institutionsTo participate in non-profit programs/projects (including schoolwellness programs) that aim to increase early detection of mentalhealthTo act as a clinical training base for education and research segmentsof Institute ZTo achieve gross revenue - 11,9m in year 7Strengths Attractive location of the hospital in an area with substantial need for such a facility Synergistic effect: hospital, education and research facilities in one place High-quality but affordably priced solutions Innovative marketing approach Experienced management team Founder substantial industry contact network will help to make the businesssuccessful extremely quicklyBusiness plan – Project E XXXX - Priv ate and Conf idential5
Executive SummarysThe Company is seeking an investment of 9m, mainly to finance CAPEX and the working capital during the first 12 months of operationsFinancialsRevenue structure, %14,000,00012,000,000Projected Profit and Loss account Year 1\Year 2Year 3Year 4Year ting expensesNet profit/(loss)816,159Year 6Year rce management information2,000,000-Year 0Year 1Year 2Outpatient servicesYear 3Year 4Year 5Inpatient servicesYear 6Year 7TelemedicineSource: Management inf ormationInitial investmentsKPIsInitial investments, ItemInitial investments, CAPEXKey performance indicatorsCF (1-7 years), NPV (1-7 years)*, IRR, %Payback periodTransportItemAmbulanceHospital Vehicles of the leased ofofthegoodsConstruction works (prefabricated modular building)Investmentsworking capitalElectricals andinplumbingOtherTotal:Medical equipmentSource: Management informationEquipment and furnitureConstruction of permanent brick structures in year 3-5Working capital12,223,112949,6964%6.5 years*Discounted rate 3%So urce: M anagement info rmatio 0009,045,000Source management informationBusiness plan – Project E6 XXXX - Priv ate and Conf idential
Market ResearchSectionPageDisclaimer2Executive Summary4Market Research7Business Model18Marketing Plan30Financial Projections37Management Team43Use of Proceeds46Business plan – Project E7 XXXX - Priv ate and Conf idential
Market ResearchGeneral OverviewGlobally, one in four people will experience psychological distress and meet criteria for a diagnosable mental disorder at some pointin their lives (WHO)General overview For years, the global burden of mental disorders on individuals,families, communities and health services has been considerablyunderestimated. Resources for mental, neurological, andsubstance use disorders have been slow in development,insufficient, constrained, fragmented, inequitably distributed, andineffectively implemented. While mental and neurologicaldisorders comprise only 1% of deaths worldwide, they account for8–28% of the disease burden, with the majority of these disordersoccurring in low- to middle-income countries.Mental Health: An International Problem Most mental disorders are highly prevalent in all societies, remainlargely undetected and untreated, and result in a substantialburden to families and communities. Although many mentaldisorders can be mitigated or are avoidable, and though theycontinue to produce significant economic and social hardship,they continue to be overlooked by the international community.Moreover, in all countries there is an enormous gap between theprevalence of mental disorders and the number of peoplereceiving care.In less-developed countries, more than 75% of persons withserious mental disorders do not receive treatment. Unfortunately,psychiatry’s best efforts at training physicians to provide mentalhealth care within the global context are proving too small tocontain the global problem.For too long, the focus has been on medicine and not on localcommunities (Patel, 2013). In fact, every person’s health care islocal (Unützer, 2013). The major issue with the current provisionof care is, therefore, the limited size and training of thecommunity health care workforce (Becker & Kleinman, 2013).Business plan – Project E8 Globally, one in four people will experience psychological distress andmeet criteria for a diagnosable mental disorder at some point in theirlives (WHO). This ominous data speaks to the need for accessible,effective and socially equitable mental health care (Hinkle & Saxena).WHO estimates that more than 450 million people worldwide live withmental health problems; these numbers are no doubt bleak. More specifically, WHO estimates that, globally, more than 154 millionpeople suffer from depression, 100 million are affected by alcohol usedisorders, 25 million have schizophrenia, 15 million abuse drugs, andnearly one million people commit suicide each year (Saraceno et al.). Depending on the source, unipolar depression has been estimated to bein the top four causes of loss of disability-adjusted life years across thesix socially diverse continents (Murray & López; Vos et al., 2012). Furthermore, it has been estimated that as many as 25% of all primarycare consultations have a mental health component (Goldberg &Huxley; Warner & Ford; WHO). Mental disorders are related to a rangeof problems, from poverty, marginalization, and social disadvantage, torelationship issues such as divorce, physical conditions such as heartdisease, reductions in economic productivity, and interruption of childand adolescent educational processes (see Alonso, Chatterji, He, &Kessler, 2013; Breslau et al., 2013). At the developmental level, at least 10% of children are considered tohave mental health problems, but pediatricians and general medicalpractitioners are not typically equipped to provide effective treatment(Craft). With mental disorders contributing to an average of 20% ofdisabilities at the societal level, the evidence is clear that thesedisorders pose a major global health challenge (Alonso, Chatterji, et al.,2013; Alonso, Petukhova, et al., 2013). Moreover, the associatedeconomic burden exceeds that of the top four non-communicablediseases (i.e., diabetes, cardiovascular, respiratory and cancer; Bloomet al., 2011). XXXX - Priv ate and Conf idential
Market ResearchValue ChainAbout 35–50% of mental health cases in developed countries and approximately 75–85% in less-developed countries have receivedno treatment in the 12 months preceding a clinical interview Most international mental health systems are dominated bycustodial psychiatric hospitals (WHO). Similarly, an informal international survey of clinical mental health,school, and career and work counselors by NBCC-I indicated that theprofessional counselor workforce has yet to be adequately identified ona global scale (Hinkle, 2010b). Moreover, extant mental health servicesare inequitably distributed; lower-income countries, where behavioralrisk factors tend to cluster among people of lower socioeconomic status,have significantly fewer mental health human resources than higherincome countries (Coups, Gaba, & Orleans; WHO; WHO World MentalHealth Survey Consortium). In low- to middle-income countries, human resources are clearly limited,and the quality and productivity of the existing workforce is oftenchallenged. Investment in human resources for community mentalhealth care is insufficient in absolute terms as well as in distribution(Hongoro & McPake). For instance, the global average for physicians is 170 per 100,000people, but in Nepal and Papua New Guinea there have been as few asfive doctors per 100,000 (WHO,). In 2009, approximately 36% of doctors’ posts and 18% of nurses’ postswere unfilled around the world (Bach). Moreover, general practitionersare not typically adept at providing mental health care, includingdetection, referral and management of mental disorders (Chisholm etal.). Therefore, partnerships between formal primary and informalcommunity health care systems need to be more prevalent, effectiveand integrated. Because psychiatric hospital beds are extremely limited, the demand formental health services within communities becomes even more critical(Forchuk, Martin, Chan, & Jensen). Furthermore, early detection andtreatment of mental disorders and co-occurring emotional andbehavioral problems not only decreases the chance of lower physicalhealth later in life, but also associated costly hospitalizations.Global Community Mental Health Serious mental disorders are generally associated withsubstantial role disability within the community. About 35–50% ofmental health cases in developed countries and approximately75–85% in less-developed countries have received no treatmentin the 12 months preceding a clinical interview. Due to the highprevalence of mild and sub-threshold cases, the number ofuntreated cases is estimated to be even larger. These mildercases, which can be found in communities all over the world,require careful consideration because those with untreated, mildcases of mental illness are far more vulnerable to cases of severemental illness (WHO, 2010a, 2010b; WHO World Mental HealthSurvey Consortium).It is important to note that in most low- to middle-incomecountries, community workers are often the people’s first line ofcontact with the health care system (Anand & Bärnighausen,2004; Hongoro & McPake, 2004). However, there is a long historyof issues with the sustainability of community programs (Walt,1988). There is a pronounced lack of community serviceproviders with the necessary competencies to address mentalhealth needs, which remains the most significant barrier to theprovision of mental health services. Although human resourcesare the crucial core of health systems, they have been aneglected developmental component (Hongoro & McPake, 2004),particularly in the field of mental health. WHO’s “Mental HealthAtlas” specifies a critical global shortage of mental healthprofessionals (e.g., psychiatrists, psychiatric nurses,psychologists, social workers, neurologists).Business plan – Project E9 XXXX - Priv ate and Conf idential
Market ResearchBotswanaMental health and mental hospital expenditures by the government health department/ministry in Botswana are less than what isneeded to grapple with the issueGeneral information about BotswanaGovernance An officially approved mental health policy exists, which was revisedand approved relatively recently (in 2003). Mental health is alsospecifically mentioned in Botswana’s general health policy guidelines. A mental health plan exists and was approved or most recently revisedin 1997. The mental health plan components include:Botswana is a country with an approximate area of 582 thousandsquare kilometers (UNO). The population is 1,977,569 and thesex ratio (men per hundred women) is 102 (UNO). The proportionof the population under the age of 18 years is 39% and theproportion above age 60 is 4% (UNO). The literacy rate is 94%for men and 96% for women (UN Statistics). The life expectancyat birth is 54 years for males and 53 years for females (UNO).The healthy life expectancy at birth is 49 years for males and 53years for females (UNPD). The country is in the upper-middleincome group. The total expenditure on health as a percentage ofgross domestic product is 10.25% and the per capita governmentexpenditure on health (PPP int. ) is 624 (WHO). In Botswana,neuropsychiatric disorders are estimated to contribute to 4.6% ofthe global burden of disease (WHO). Funding allocation for the implementation of half or more ofthe items in the mental health plan. Shift of services and resources from mental hospitals tocommunity mental health facilities. Integration of mental health services into primary care.Dedicated mental health legislation exists and was initiated, or mostrecently revised, in 1971. Legal provisions concerning mental health arealso covered in other laws (e.g. welfare, disability, general healthlegislation etc.).Financing Though steps are being taken to address mental health issues inBotswana, mental health and mental hospital expenditures by thegovernment health department/ministry are less than what is needed tograpple with the issue.Mental health care deliveryPrimary Care Business plan – Project E10Prescription regulations authorize primary health care doctors toprescribe and/or to continue prescription of psychotherapeuticmedicines but with restrictions. Similarly, the department of healthauthorizes primary health care nurses to prescribe and/or to continueprescription of psychotherapeutic medicines but with restrictions. XXXX - Priv ate and Conf idential
Market ResearchMental Health ServicesStatistics – mental health services in Botswana Official policy also enables primary health care nurses toindependently diagnose and treat mental disorders within theprimary care system.Officially approved manuals on the management and treatment ofmental disorders are available in most primary health care clinics.Official referral procedures for referring persons from primarycare to secondary/tertiary care exist, as do referral proceduresfrom tertiary/secondary care to primary care.Mental Health ServicesHuman resourcesWorkforce and trainingPsychiatristsMedical doctors, not specialized in psychiatryHealthprofessionalsw orking in them ental healthsector Rate per100.0000.250.51Training of healthprofessions ineducationalinstitutions Rate per100.0000.00.0Availability of mental health facilitiesTotal num ber offacilities/ bedsMental health outpatient facilitiesDay treatment facilitiesPsychiatric beds in general hospitalsCommunity residential facilitiesBeds places in community residential facilitiesMental hospitalsBeds in mental hospitalsRate per 6.79Num ber ofRate perfacilities/beds100,000reserved forpopulationchildren andadolescents tsSocial w orkersOccupational therapistsOther health w orkersRates per 100,000population)Persons treated in mental health outpatient facilities541.93Persons treated in mental health day treatmentfacilitiesAdmissions to psychiatric beds in general hospitalsUNPersons staying in community residential facilities atthe end of the yearAdmissions to mental hospitalsUNUN93.04So urce: Department o f M ental Health and Substance A buse, Wo rld Health Organizatio nUN information unavailable, NA item not applicableBusiness plan – Project E18.051.52UN1.82NASo urce: Department o f M ental Health and Substance A buse, Wo rld Health Organizatio nInformation SystemsData on number of Data on age andpeople/ activitiesgender are collectedare collected and and reportedreportedSo urce: Department o f M ental Health and Substance A buse, Wo rld Health Organizatio nAccess to care4.051.520.351.822.38Data on patient'sdiagnosis arecollected andreportedPersons w ith mental disorders treated in primaryhealth careInterventions (psychopharmacological andpsychosocial) delivered in primary health care forpeople w ith mental disorderPersons treated in mental health outpatient facilitiesYesYesYesYesYesYesYesYesYesContacts in mental health outpatient facilitiesPersons treated in mental health day treatmentfacilitiesAdmissions in general hospitals w ith psychiatricbedsAdmissions in mental hospitalsDays spent in mental hospitalsAdmissions in community residential esYesYesYesYesSo urce: Department o f M ental Health and Substance A buse, Wo rld Health Organizatio n11 XXXX - Priv ate and Conf idential
Market ResearchPsychology inBotswanaAs opposed to neighboring South Africa, Botswana does not have a long history of psychology as a professionPsychology and its status in BotswanaPsychological services in Botswana As opposed to neighboring South Africa, Botswana does not havea long history of psychology as a profession. Psychology is arelatively new discipline in Botswana; therefore, there is littlepublished literature. Botswana has very few practicingpsychologists or registered counselors. Those who practice inBotswana were trained either overseas or in the neighboringcountries, such as South Africa and Zambia. In addition, thosewho are trained in psychology find employment mostly in theareas of lecturing, human resources, or other work not directlyrelated to their areas of clinical training. In Botswana, psychologists are required to register with theBotswana Health Professions Council (BHPC). Currently, theBotswana Health Professions Council (BHPC) Act onlyrecognizes and registers clinical psychologists and is silent aboutother categories (Botswana Health Professions Chapter 61:02).This indicates that there is an information gap in terms of anunderstanding of the scope of psychology as a profession inBotswana. Botswana is grappling with a host of issues, including social,psychological, and behavioral problems, HIV/AIDS, and the need forpsychological assessment in the workplace. These issues may have adirect impact on Botswana’s economic and social development if they arenot handled professionally. in an attempt to address these issues, theBotswana government introduced and effected health and social welfarestructures that provide counseling, psychological assessment andHIV/AIDS voluntary counseling and testing services (VCT). They furtherstated that the impact of these structures has been inhibited, either by alack of awareness of such services by the public or underutilization of theservices by primary health care providers. The ability of a nation orcommunity to withstand social crises or serious conflicts is directly relatedto the quality of health, as well as the psychological wellbeing, of thenation. There have, however, been efforts to bring psychologists togetherto speak with one voice to address issues of credentialing andethics and lobby for the recognition of psychology as aprofession. After periodic efforts, the Psychological Association of Botswana(PAB) was formed in 2005 and was registered as an associationin 2007 (Psychological Association of Botswana Handbook). Psychological services that do exist in Botswana are provided throughhealth and welfare structures and the education sector. Otherpsychological services that exist belong to non-governmental organisationsand agencies (Directory of Counseling Services in Botswana), religiousorganizations, traditional doctors and family members also play a majorrole in rural areas. On the next slide is a table from the Directory ofCounseling Services in Botswana, indicating some of the governmentinstitutions and non governmental organizations that offer psychologicalservices. In an attempt to offer psychological services at health centers, governmentpolicymakers have introduced psychological services at the primary healthcare level. Clinical psychologists are attached to Botswana’s three mainreferral hospitals, namely Marina and Nyangabwe Referral Hospitals andLobatse Mental Hospital (Ministry of Health). Psychological services atcommunity health centers are often offered by medical doctors, nurses andsocial workers who do not have the relevant training in psychologicalintervention skills.Unfortunately, the association does not have any powers toregulate and protect the practice of psychology or the provision ofpsychological services.Business plan – Project E12 XXXX - Priv ate and Conf idential
Market ResearchPsychologyPsychological services that do exist in Botswana are provided through health and welfare structures and the education sector Psychological service offered in BotswanaThough these professionals make valiant efforts to providepsychological services, many of them have not been give thetools or resources they need to understand the diverse causes ofpsychological problems and, therefore, they often lack theexpertise to offer effective psychological intervention.In the nation’s schools, the guidance and counseling division inthe Ministry of Education is charged with the responsibility ofproviding psychological services in Botswana’s schools, from preprimary schools to tertiary institutions. Psychological services areoffered, which include training teachers how to guide and counseltheir students while adhering to the ethical principles ofcounseling. They provide counseling to individuals and groups ona wide range of issues.As psychology as a profession is a relatively new discipline inBotswana, this may result in the role of a psychologist in thehealth care setting and the community in general being unclear.The fact that social workers, counselors and guidance andcounseling teachers are charged with the responsibility of offeringpsychological services, and therefore function as psychologists,adds to the misconception regarding the roles of theseprofessionals.Botswana has outlined a longer-term vision, which they hope toachieve by 2016, including the goal of building a compassionate,just and caring nation that addresses the need to strengthen thehealth care system and to ensure that Botswana is a healthynation so that its citizens can contribute meaningfully to thecountry’s development (Long-Term Vision for Botswana). Thisrequires a coordinated program of health promotion and diseaseprevention services, as well as a functioning primary healthsystem and the provision of high-quality health services to thosewho require secondary and tertiary care (Long-Term Vision forBotswana.Business plan – Project ECityInstitutionCounselling services offeredFrancistow nPeer Approach to Counselling byTeensEquip youth w ith social skills and relationshipmanagementFrancistow nYoung Women's ChristianAssociation (YWCA)Youth counseling and peer pressuremanagement skillsFrancistow nRed Cross Blood DonationProgrammePre-and-post-blood donation counselling toblood donorsFrancistow nTebelopele Voluntary Counselling and Pre-and-post counselling for HIV testingHIV Testing CentreCounselling services to individuals directly orindirectly affected by HIV/AIDS3ana Consultancy (BANACO)Pre-and-post information and assistance toprofessionals w orking w ith children and theirfamiliesBotsw ana Family WelfareAdvocate and provide information andAssociation (BOFWA)education oc human grow th, reproduction andsexual development Advice on pre-mantal andmantal counselling, family and couplecounsellingCareers and Counselling Centre.Career assessment and counsellingUniversity of Botsw anaGaboroneGaboroneGaboroneGaboroneCoping Centre for People Living w ittHIV/ AIDSGaboroneHoly Cross ng services to people living w ith HIVAIDSFacilitate and strengthen support groups ofpeople living w ith HIV AIDSTinsanyo Catholic CommissionBehavioural change based on Christianteaching. Provide care and counsellingservices to individuals living w ith HIV. AIDSand orphansTshepong C ounselling Netw orkPsychocherapeutic interventionsGuidance and Counselling Division. Career counselling Job placemen and skillsCurriculumDevelopmentand trainingEvaluationTebelopele Voluntary Counselling and Pre-and-post counselling for HIV testingHIV Testing CentreCounselling services to individuals directly orindirectly affected by HIV/AIDS XXXX - Priv ate and Conf idential
Market ResearchPrimary Health Care inBotswanaCurrently, two health care systems run concurrently in Botswana, one western and the other a more traditional form of health care Some of the ways to enhance realization of the health-promotiongoals of vision 2016 is to explore the awareness of psychologicalservices within the health care system, to assess the attitudes ofhealth care providers towards psychology and to explore theirreferral practices with regard to psychological problems.According to Vogelman, the important ingredients for achievingappropriate service delivery include a multi-disciplinary teamapproach, preventative interventions and the appropriate use ofhealth professionals. The National Development Plan 7 (NDP 7) of 1985 -1991 brought a shifttowards an integrative approach where mental health forms an integralpart of primary health care (Manual of Health C
Financial Projections 37 Management Team 43 Use of Proceeds 46 2 Disclaimer. Business plan –Project E XXXX - Private and Confidential Disclaimer 3 This presentation has been prepared exclusively for the benefit and internal use of a qualified sophistica
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